The Certified Professional Coder: Expert Questions and Answers

The Certified Professional Coder quiz is specially designed to cover all the key areas you need to master for the CPC exam. It encompasses a broad spectrum of topics, essential for any aspiring medical coder. This includes coding for radiology, pathology laboratory, general medicine, and understanding the nuances of the Healthcare Common Procedure Coding System (HCPCS) Categories II and III. Additionally, it delves into aspects of practice management, a vital component of healthcare administration.

Suggested Course Quiz with Expert Answers:

Coding and billing language is used to assist _____________________________ in understanding why the patient was seen and what services, procedures, or supplies were provided for the patient.

A) third-party administrators and customer service representatives
B) collection agencies and hospitals
C) patients and collection agencies
D) physician offices and patients

Accounts receivable, denials, and modifiers are examples of _____________ language.

A) Provider
B) Billing
C) Compliance
D) Payer

Any diagnosis, condition, procedure, or service that is documented in the patient record as having been treated or medically managed demonstrates:

A) medical support
B) medical documentation
C) medical management
D) medical necessity

The Certified Professional Coder (CPC) exam tests the coder’s skill in translating data from the patient’s medical record accurately and completely so that the provider is:

A) Reimbursed correctly and fairly
B) Able to hire additional staff
C) Exempt from audits
D) Reimbursed regardless of compliance guidelines

Medical coding is defined as:

A) The process of translating provider documentation into codes
B) Identifying noncovered services
C) Verifying services are covered by a payer prior to providing the services
D) The process of reporting patient index information to payer auditors

An ICD-10-CM (tenth revision) code represents:

A) the diagnosis
B) the demographics
C) the service
D) the procedure

The CPC exam is an “open code-book” exam. All of the following are approved coding manuals for use during the exam except:

A) ICD
B) HCPCS
C) CPT
D) DSM-5

The _____ exam is a 150-question exam that thoroughly tests the coder’s ability within a medical coding subset.

A) Certified Coding Specialist
B) National Billing and Insurance Specialist
C) Certified Professional Coder
D) Certified Coding Associate

Revenue included in the accounts receivable cycle may be due to the provider from all of the following except:

A) workers’ compensation
B) recovery audit contractors
C) health insurance coverage
D) the patient

Approximately ____________ percent of members of the American Academy of Professional Coders are credentialed as Certified Professional Coders.

A) 50
B) 60
C) 80
D) 70

A diagnosis which may not receive direct treatment during an encounter but which the provider has to consider when determining treatment for other conditions is called a:

A) Medically managed diagnosis
B) Concurrent diagnosis
C) Additional diagnosis
D) Secondary diagnosis

The flow of a practice’s revenue, which begins when charges for services, procedures, or supplies are incurred and continues until those charges are paid in full or adjusted off the account is called:

A) revenue cycle
B) contractual adjustment cycle
C) accounts payable cycle
D) accounts receivable cycle

The CPC exam tests the coder’s ability and understanding of which content areas?

A) Radiology, DRGs, Advanced Beneficiary Notices, and Anesthesia
B) DRGs, HCPCS Level II, and Anesthesia
C) HCPCS Level II, Radiology, and DRGs
D) Radiology, Anesthesia, and HCPCS Level II

Selection of ICD, CPT, and HCPCS codes is based on _____________ language.

A) provider
B) payer
C) billing
D) compliance

The demographic portion of the CMS 1500 form:

A) Contains information such as the services provided on a date of service
B) Is found at the top of the form
C) Is found at the bottom of the form
D) Contains information such as the patient’s medical condition

The foundation of a coder’s role is to:

A) Determine each patient’s chief complaint and communicate this to the physician
B) Follow office guidelines and procedures when scheduling patients
C) Make each patient feel comfortable while obtaining vital signs
D) Interpret different languages and correctly translate them into data for the CMS 1500 form

Creating a clean claim requires that all involved in its creation have all of the following except:

A) A good working knowledge of each of the patient’s medically managed conditions
B) A good working knowledge of government regulations
C) A good working knowledge of payer policies
D) A good working knowledge of the practice/provider-payer contract limitations

To be of value to the practices or organizations they work for, medical coders should:

A) Memorize all procedure codes
B) Consistently audit the use of ICD-10 codes
C) Demonstrate strong organizational skills
D) Be diligent in maintaining and updating their knowledge of medical coding and billing policies

One of the more common reasons for a coder performing poorly on the exam when he/she knows the material well is:

A) The coder experiences test anxiety
B) The coder forgot to bring No. 2 pencils
C) The coder forgot to bring headphones
D) The coder brought all permitted coding manuals

Certified coders, on average, earn _____ percent more than noncertified coders.

A) 30
B) 20
C) 15
D) 10